Recurrent intracerebral haemorrhage (ICH) presents a complex clinical challenge that eludes traditional diagnostic and treatment approaches. We report a rare and unexplained case of a middle-aged patient with recurrent ICH, for which extensive multidisciplinary investigations have yet to provide a definitive diagnosis or an effective long-term treatment strategy. Intraoperative pathology, genetic testing, cerebral angiography, inflammatory markers (erythrocyte sedimentation rate, C-reactive protein), specific antibodies (ANCA, anti-nuclear antibodies), and immunoglobulin levels showed no specific positive findings. This case highlights the limitations of current diagnostic and therapeutic modalities in recurrent ICH. Further research into the genetic and molecular underpinnings of recurrent ICH is needed to enhance diagnostic accuracy and develop targeted therapies for similar cases.